Indiana gets federal approval for Medicaid plan that could slice enrollment

New Medicaid rules in Indiana require adult program participants who qualified for coverage under the Affordable Care Act to present proof of employment or be shut out of enrollment for 3 months. Along with another previously established "lockout" clause, which puts a 6-month block on enrollees who neglect to pay the monthly premium and are above the federal poverty line, the change could cost the program tens of thousands of beneficiaries. “The 'lockout” is one of the worst policies to hit Medicaid in a long time,” according to Joan Alker, executive director of the Georgetown University Center for Children and Families. “Forcing people to remain uninsured for months because they missed a paperwork deadline or missed a premium payment is too high a price to pay. From a health policy perspective it makes no sense because during that period, chronic health conditions such as hypertension or diabetes are just likely to worsen.” More than 91,000 enrollees were bounced out of the system since 2015 under the existing lockout criteria, and Indiana officials project that the newer language could cut enrollment by 1% in the first year. It also will generate a $15 million reduction in Medicaid costs in 2018 and an estimated $32 million in savings next year, they say. Indiana is the second state, after Kentucky, to win federal approval for a work requirement for adult Medicaid recipients.